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https://www.readbyqxmd.com/read/28817452/cms-mds-3-0-section-m-skin-conditions-in-long-term-care-pressure-ulcers-skin-tears-and-moisture-associated-skin-damage-data-update
#1
Elizabeth A Ayello
GENERAL PURPOSE: The purpose of this learning activity is to provide information about the updates to the Centers for Medicare & Medicaid Services (CMS) MDS 3.0 Section M, Skin Conditions documentation in long-term care. TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant should be better able to:1...
September 2017: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/28817444/strategies-for-reducing-population-surgical-costs-in-medicare-local-referrals-to-low-cost-hospitals
#2
Hari Nathan, Jyothi R Thumma, Edward C Norton, Justin B Dimick
OBJECTIVE: We sought to assess hospital cost variation for elective inpatient surgical procedures within small geographic areas. SUMMARY BACKGROUND DATA: Previous studies have documented cost variation for inpatient surgical procedures on a national basis, suggesting opportunities for savings. Cost variation within small geographic areas is more relevant to policymakers, providers, and patients, but it has not been studied. METHODS: Using Medicare payment data, we identified elderly patients undergoing 1 of 7 elective inpatient surgical procedures during 2010-2012...
August 16, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28815974/health-promotion-in-fiji-is-it-feasible-in-the-emergency-department
#3
Anne Creaton, Jackie Holt
OBJECTIVES: Complications of diabetes, hypertension and asthma are commonly seen in EDs in Fiji. Time spent in the ED offers an opportunity for health promotion activities. The aim of the intervention was to provide information on diabetes, hypertension and asthma to patients in the ED. The aim of the project was to determine whether such an intervention could be implemented using public health students. The aim of this paper is to document the experiences of those who delivered and supervised the intervention...
August 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28814303/data-collection-of-patients-with-diabetes-in-family-medicine-a-study-in-north-eastern-italy
#4
Alberto Vaona, Franco Del Zotti, Sandro Girotto, Claudio Marafetti, Giulio Rigon, Alessandro Marcon
BACKGROUND: Studies on data collection and quality of care in Italian family medicine are lacking. The aim of this study was to assess the completeness of data collection of patients with diabetes in a large sample of family physicians in the province of Verona, Veneto region, a benchmark for the Italian National Health System. METHODS: We extracted the data on all the patients with diabetes from the electronic health records of 270 family physicians in 2006 and 2009...
August 16, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28812844/clinician-perspectives-of-barriers-to-effective-implementation-of-a-rapid-response-system-in-an-academic-health-centre-a-focus-group-study
#5
John Rihari-Thomas, Michelle DiGiacomo, Jane Phillips, Phillip Newton, Patricia M Davidson
BACKGROUND: Systemic and structural issues of rapid response system (RRS) models can hinder implementation. This study sought to understand the ways in which acute care clinicians (physicians and nurses) experience and negotiate care for deteriorating patients within the RRS. METHODS: Physicians and nurses working within an Australian academic health centre within a jurisdictional-based model of clinical governance participated in focus group interviews. Verbatim transcripts were analysed using thematic content analysis...
January 1, 2017: International Journal of Health Policy and Management
https://www.readbyqxmd.com/read/28809636/-arthroscopic-finding-of-knee-joint-in-relation-to-age-and-its-comparison-with-pre-operative-clinical-finding-a-retrospective-study
#6
P Látal, K Šimeček, M Kloub
PURPOSE OF THE STUDY In the retrospective study of two South Bohemian centres we present the comparison of pre-operative anamnestic clinical signs in relation to the arthroscopic intraoperative finding. The obtained data is used also to evaluate the arthroscopic finding in relation to age and sex. MATERIAL AND METHODS The arthroscopic findings of patients who underwent surgery in 2013-2014 period (1.1.2013-31.12.2014) at the Department of Trauma Surgery of České Budějovice Hospital, a.s. and in 2014 (1.1...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28806026/physician-perceptions-of-barriers-to-advance-care-planning
#7
Lauren Fanta, Jill Tyler
BACKGROUND: Numerous studies have confirmed the importance of advance care planning. Despite the benefits of directed end-of-life discussions, a variety of barriers including discomfort with the topic, physician ideology, lack of time and reimbursement, delaying discussions, and lack of training impede physicians from facilitating these crucial conversations with their patients. This study aims to understand physicians' perceptions to additional barriers to advance care planning with patients and their families...
July 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28803223/social-responsibilities-of-a-physician-reflections-of-major-general-s-l-bhatia-1891-1981
#8
Radhika Hegde, Mario Vaz
This paper examines various documents written by Major General SL Bhatia CIE, MC, IMS from the 1920s to the1960s on the "Social Responsibilities of a Physician". His reflections are of historical significance, since they provide us with an insight into the challenges confronting the people who attempted to rebuild a nation plagued by poverty resulting from fractured agricultural growth, a feudalistic social structure and the regional inequalities that accompany it, and prolonged imperial rule, among other things...
July 25, 2017: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/28803074/hospice-palliative-care-development-in-hungary
#9
Agnes Csikos, Csilla Busa, Katalin Muszbek
During the past 25 years many developmental steps have occurred in Hungary in palliative care. Further education and service development is needed to provide a quality palliative care for all the Hungarian people. Hungary has a universal health care system with a developed infrastructure. The first Hungarian hospice team started in 1991. At that time the concept of hospice care was unknown. Symptom control and psychosocial support for the dying patient was inadequate. The regulatory framework was based on the 1997 Health Care Act which was followed by significant palliative care legislation including documents on the legal requirements for palliative care (2004)...
August 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28801654/perceptions-of-asthma-control-in-the-united-kingdom-a-cross-sectional-study-comparing-patient-and-healthcare-professionals-perceptions-of-asthma-control-with-validated-act-scores
#10
Andrew Menzies-Gow, Gavin Chiu
Perceptions of asthma control often vary between patients and physicians. This cross-sectional survey provided UK-specific data on actual and perceived asthma control in patients (18-75 years) attending routine asthma reviews in primary, secondary and tertiary settings. Differences between healthcare professionals' (HCP) and patients' perceptions of asthma control were evaluated via an online questionnaire and compared to a control-the validated asthma control test (ACT)-which patients completed. Treated patients (at least a short acting ß-agonist) with a documented diagnosis of asthma were enroled and consented within a month of their last appointment...
August 11, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28800832/knowledge-of-appropriate-outpatient-pediatric-echocardiogram-ordering-in-primary-care-physicians-and-trainees
#11
Sean M Lang, Joshua A Daily, Micheal R FitzGerald, Xinyu Tang, Thomas H Best, James M Robbins, R Thomas Collins
Appropriate Use Criteria (AUC) for the initial use of outpatient pediatric echocardiography were established to aid all clinicians in the evaluation of children with possible heart disease, and limit low diagnostic yield studies. We sought to (1) assess PCPs' and trainees' awareness of the AUC document; (2) compare their knowledge of appropriate echocardiogram ordering with that of pediatric cardiologists; and (3) identify additional medical and nonmedical factors affecting PCP echocardiogram ordering. An online survey with clinical scenarios derived from the AUC guidelines was distributed to PCPs and trainees in Arkansas, and pediatric cardiologists from Arkansas Children's Hospital and Cincinnati Children's Hospital Medical Center...
July 14, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28797376/advance-care-planning-in-the-outpatient-geriatric-medicine-setting
#12
REVIEW
Bryan David Struck, Elizabeth Aubrey Brown, Stefani Madison
This article describes how to perform advance care planning in the outpatient geriatric medicine setting. The article defines advance care planning and discusses components of advance care planning, such as advance directives, do-not-resuscitate orders, and Physician Orders for Life-Sustaining Treatment. The article describes how to document advance care planning discussions in the clinic and bill Medicare and ways for clinicians to improve their skill at leading these conversations.
September 2017: Primary Care
https://www.readbyqxmd.com/read/28795915/where-teachers-are-few-documenting-available-faculty-in-five-tanzanian-medical-schools
#13
Charles A Mkony, Ephata E Kaaya, Alex J Goodell, Sarah B Macfarlane
Background Faced with one of the lowest physician-to-population ratios in the world, the Government of Tanzania is urging its medical schools to train more physicians. The annual number of medical students admitted across the country rose from 55 in the 1990s to 1,680 approved places for the 2015/16 academic year. These escalating numbers strain existing faculty. Objective To describe the availability of faculty in medical schools in Tanzania. Design We identified faculty lists published on the Internet by five Tanzanian medical schools for the 2011/12 academic year and analyzed the appointment status, rank, discipline, and qualifications of faculty members...
December 2016: Global Health Action
https://www.readbyqxmd.com/read/28794548/informed-consent-process-foundation-of-the-researcher-participant-bond
#14
Amrita Sil, Nilay Kanti Das
Consenting to participate in a clinical research study after being properly and correctly informed upholds the basic ethical principle of "autonomy" in human research. The informed consent is a process by which the physician sensitizes the patient about the nature, procedures, risks benefits, treatment schedules, etc of the study in a language that is non-technical and understandable by the study participant. Informed consent document (ICD) has got two parts: the 'Subject Information Sheet' and the 'Informed Consent Form' (ICF); and they have to be approved by the Institutional Ethics Committee (IEC) before administration...
July 2017: Indian Journal of Dermatology
https://www.readbyqxmd.com/read/28793065/infrastructure-evaluation-of-pharmaceutical-services-in-the-national-health-system-of-minas-gerais
#15
Mariana Michel Barbosa, Marina Morgado Garcia, Renata Cristina Rezende Macedo do Nascimento, Edna Afonso Reis, Augusto Afonso Guerra, Francisco De Assis Acurcio, Juliana Álvares
Objectives: To characterize the infrastructure of public pharmacies in Minas Gerais, comparing municipalities that have received the RFM program to the ones that haven't, in order to verify if the State's Economic Incentives implied in improvement of local Pharmaceutical Services (PS). Methods: A cross-sectional, exploratory, evaluative study in a representative sample of the municipalities of Minas Gerais. Face-to-face interviews were conducted with users, physicians, and drug dispensers, as well as observation of pharmacy facilities and telephone interviews with municipal officials from the PS...
August 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28792986/-implementation-of-the-mobile-emergency-medical-service-in-brazil-action-strategies-and-structural-dimension
#16
Gisele O'Dwyer, Mariana Teixeira Konder, Luciano Pereira Reciputti, Cesar Macedo, Monica Guimarães Macau Lopes
The Mobile Emergency Medical Service (SAMU) was the first component of the National Policy for Emergency Care implemented in Brazil in the early 2000. The article analyzed the implementation of mobile pre-hospital emergency care in Brazil. The methods included document analysis, interviews with state emergency care coordinators, and an expert panel. The theoretical reference was the strategic conduct analysis from Giddens' Structuration Theory. The results showed uneven implementation of the SAMU between states and regions of Brazil, identifying six patterns of implementation, considering the states' capacity to expand the population coverage and regionalize the service...
August 7, 2017: Cadernos de Saúde Pública
https://www.readbyqxmd.com/read/28791242/an-online-academic-writing-and-publishing-skills-course-help-syrians-find-their-voice
#17
Ammar Sabouni, Abdelkader Chaar, Yamama Bdaiwi, Abdulrahman Masrani, Heba Abolaban, Fares Alahdab, Belal Firwana, Ahmad Al-Moujahed
PURPOSE: A group of Arab-American physicians and researchers in the United States organized a blended online course in academic writing and publishing in medicine targeting medical students and physicians in war-torn Syria. This was an effort to address one of the reasons behind the poor quantity and quality of scientific research papers in Syria and the Arab region. In this paper, we report on the design, conduct, and outcome of this course and attempt to evaluate its effectiveness. METHODS: The educational intervention was a 2-month blended online course...
July 2017: Avicenna Journal of Medicine
https://www.readbyqxmd.com/read/28790500/personomics-and-precision-medicine
#18
Roy C Ziegelstein
The importance of knowing patients as individuals has been highlighted throughout the history of medicine. However, shorter visits, electronic documentation, reliance on technology, and increasing linguistic and cultural differences between patients and physicians create more challenges to effective communication than ever before. Perhaps more concerning is the greater emphasis on aspects of care considered more precisely measurable and quantifiable, the sum of which is sometimes felt to represent the patient better than knowledge of the patient himself...
2017: Transactions of the American Clinical and Climatological Association
https://www.readbyqxmd.com/read/28790488/ethics-and-professionalism-2016
#19
C Ronald Mackenzie
Whether a reaction to events in the clinical arena, a consequence of technological innovation, or the legitimization of the marked ethos in health care, the field of medical ethics has become a complex domain in our time. Indeed, the ubiquity of ethical dilemmas in the provision of health care is well documented with more than 99% of primary care physicians reporting ethical problems arising in the conduct of their practices (1-3). Although commentary relating to this domain has most often originated in the primary care setting, hospital-based medicine and its ethics committees are another fertile source, as is medical research...
2017: Transactions of the American Clinical and Climatological Association
https://www.readbyqxmd.com/read/28782703/the-contribution-of-the-international-pain-policy-fellowship-in-improving-opioid-availability-in-georgia
#20
Pati Dzotsenidze, Martha A Maurer, Dimitri Kordzaia, Ioseb Abesadze, Mary M Skemp Brown, Aaron M Gilson, James F Cleary
In the Republic of Georgia, the incidence and prevalence of cancer is increasing, signifying a growing need for palliative care and pain relief, including with controlled opioid medicines. As a signatory to the Single Convention, the Georgian government has a responsibility to ensure the adequate availability of controlled medicines for medical purposes, however the consumption of morphine is very low, suggesting a high occurrence of unrelieved pain. In Georgia, palliative care development began in the 2000s including the adoption of a policy document in 2005, the creation of the National Palliative Care Coordinator in 2006 and important changes in Georgian legislation in 2007 and 2008, which served to lay a foundation for improving opioid availability...
August 3, 2017: Journal of Pain and Symptom Management
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